Abstract
BackgroundPulmonary side effects are well known, including lung fibrosis, in elderly patients treated with long-term nitrofurantoin to prevent urinary tract infections and secondary renal injury. However, pulmonary side effects have only been reported rarely in paediatric cases, despite nitrofurantoin being a first line prophylactic treatment of recurrent childhood urinary tract infection.Case presentationsA 6-year-old girl was admitted to the hospital with dyspnea, general fatigue, loss of appetite and need for nasal oxygen treatment after long-term nitrofurantoin treatment. A computed tomography scan of the chest showed lung fibrosis. A biopsy confirmed this diagnosis. We suspected the fibrosis to be caused by the nitrofurantoin treatment. Thorough examinations reveal no other explanations. Nitrofurantoin was discontinued and the girl was treated with methylprednisolone. After 17 month a new scan and lung function test showed total regression of the lung fibrosis.ConclusionsThis case underlines that risk of severe side effects should be taken in to account before initiation of long-term nitrofurantoin treatment in children.
Highlights
Pulmonary side effects are well known, including lung fibrosis, in elderly patients treated with longterm nitrofurantoin to prevent urinary tract infections and secondary renal injury
This case underlines that risk of severe side effects should be taken in to account before initiation of long-term nitrofurantoin treatment in children
We report a case of a 6-year-old girl who developed dyspnea and interim need for nasal oxygen treatment due to pulmonary fibrosis manifesting after 2 years of nitrofurantoin treatment
Summary
Pulmonary side effects are well known, including lung fibrosis, in elderly patients treated with longterm nitrofurantoin to prevent urinary tract infections and secondary renal injury. Conclusions: This case underlines that risk of severe side effects should be taken in to account before initiation of long-term nitrofurantoin treatment in children. Background Nitrofurantoin has been a first line antibiotic choice in prophylactic treatment of childhood urinary tract infection.
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